BACKGROUND/IMPORTANCE OF THE STUDY

At present, there is not much data on the prevalence of cancer in the young adult population in the local setting, in addition to prevalence and determinants of distress in this population. The findings of this study may help to understand the current situation of this young population, and it may also provide a reference for further improving outcomes among these patients who have a distinct set of needs compared to the older counterparts, in addition to a long life expectancy ahead of them.

STUDY DESIGN

This study employed an observational cross-sectional design that included young adult cancer patients, aged 19 to 39 years old, seen at the hospital outpatient clinics and Cancer Center from October 2023 to December 2023. Demographic and clinical data were collected. The participants were also asked to fill out the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) Screening Tool and Problem List after signing the written informed consent. Data were collated and analyzed per clinical variable.

RESULTS/ANALYSIS

The mean age of the participants was 34.55 years (SD=3.97), with most of them being 36 to 39 years old (51.67%). Comparative analyses of different demographic and clinical characteristics indicated that none of the characteristics were significantly different between those without and with significant distress levels (p >0.05). The mean distress score was 4.11 (SD=2.60) and categorizing these scores using the established cut-off score showed that 58.33% (95% CI = 44.88% to 70.93%) had distress. Time from cancer diagnosis significantly predicted distress development, specifically between 6 and 12 months from cancer diagnosis (aOR = 0.03, p = 0.042). Factors significantly contributing to distress are concerns on changes in eating, loss or change of physical abilities, worry or anxiety, sadness or depression, loss of interest or enjoyment, loneliness, changes in appearance, feelings of worthlessness or being a burden, relationship with friends, ability to have children, taking care of oneself, finances, access to medicine, issues on sense of meaning or purpose, and on death, dying and afterlife (pCONCLUSION

Significant distress is present in more than 50% of young adult cancer patients seen in a private tertiary institution in the Philippines. The time from cancer diagnosis significantly predicted distress development. Emotional and practical concerns significantly contributed to distress in this population.

Human ; Male ; Female ; Young Adult: 19-24 Yrs Old ; Adult: 25-44 Yrs Old ; Neoplasms ; Life Expectancy ; Tertiary Care Centers

Background: Triple-negative breast cancer (TNBC) comprises 15-20% of all breast cancers and is marked by early relapse and poor overall survival. Adjuvant chemotherapy has become the standard of care for these patients albeit to this time there is no consensus on its optimal chemotherapy regimen. This study determined the disease-free-survival (DFS) and overall survival (OS) of patients with stage I-III triple-negative breast cancer given adjuvant chemotherapy in Makati Medical Center from 2000 to 2015. Methods: A single institution (Makati Medical Center), retrospective cohort was conducted involving 157 stage I-III triple-negative breast cancer patients, diagnosed from January 2000 to June 2015, who completed an adjuvant chemotherapy regimen and had at least 3 years of follow up with their medical oncologist. Review of charts of these patients was done, and the demographic, clinical, histopathologic, chemotherapy, recurrence and mortality data were collected and analyzed. The OS and DFS rates were estimated using the Kaplan-Meier method. Results: 107 stage I-III triple-negative breast cancer patients who met eligibility criteria were included in the analysis. The most common chemotherapy regimens were sequential anthracycline-taxane (32 patients, 29.09%) and anthracycline-based regimens (32 patients, 29.09%). The 5-year median OS of TNBC patients given adjuvant chemotherapy was 78.94% (95% CI: 69% to 86%) while the 5-year median DFS of TNBC patients was 71.71% (95% CI: 61.68% – 79.5%). There was no significant association between overall survival or disease-free survival and treatment with a particular chemotherapy regimen. Conclusions Adjuvant chemotherapy with sequential anthracycline-taxane, concurrent anthracycline-taxane, CMF, anthracycline-based and taxane-based regimens among stage I-III triple-negative breast cancer patients in Makati Medical Center resulted in comparable overall survival and disease-free survival. The use of immune checkpoint inhibitors presents a viable option in TNBC as demonstrated in the Impassion 130 and KEYNOTE 119 trials, and should be further evaluated in the Philippine setting.
Triple Negative Breast Neoplasms ; Chemotherapy, Adjuvant ; Disease-Free Survival